Azathioprine in dermatology: a survey of current practice in the U.K

• Published in: British journal of dermatology (1951) Vol. 136; no. 3; pp. 351 - 355
• Main Authors: TAN, B.B., LEAR, J.T., GAWKRODGER, D.J., ENGLISH, J.S.C.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.03.1997; Blackwell
• Subjects: Azathioprine - adverse effects; Azathioprine - therapeutic use; Biological and medical sciences; Bone Marrow - drug effects; Dermatitis, Atopic - drug therapy; Dermatology; Drug Administration Schedule; Health Care Surveys; Humans; Immunosuppressive Agents - adverse effects; Immunosuppressive Agents - therapeutic use; Medical sciences; Methyltransferases - blood; Pemphigoid, Bullous - drug therapy; Pemphigus - drug therapy; Pharmacology. Drug treatments; Practice Patterns, Physicians; Skin Diseases - drug therapy; Skin, nail, hair, dermoskeleton; United Kingdom; Human; Chemotherapy; Skin disease; Treatment; Review; Immunosuppressive agent; Azathioprine
• ISSN: 0007-0963; 1365-2133
• DOI: 10.1046/j.1365-2133.1997.d01-1198.x

Summary Azathioprine has an important role in treatment of many inflammatory dermatoses. In view of the current emphasis on evidence‐based medicine, we performed a questionnaire‐based survey to establish current practice in the use of azathioprine by consultant dermatologists and associate specialists in the U.K. The response rate was 68%. In contrast with the manufacturer's recommendation, our data provide evidence that azathioprine is useful in the treatment of a wide variety of dermatological diseases. However, there is still a need for controlled trials in some conditions. The most common conditions treated were pemphigoid, pemphigus and atopic eczema. In addition, we found that only 13% of dermatologists prescribe azathioprine according to body weight. Most dermatologists felt that azathioprine was well tolerated. No one tested for thiopurine methyltransferase (TPMT) activity, which is thought to be a predictor of severe myelosuppression. The combination of prescribing azathioprine according to body weight and measuring TPMT activity would optimize efficacy and minimize potential severe myelotoxicity.